Leiomyoma volume changes at follow-up after uterine artery embolization: correlation with the initial leiomyoma volume and location.

Purpose: To study the changes in uterine leiomyoma volume after uterine artery embolization (UAE) and to correlate these changes with the initial tumor volume and location within the uterus.

Materials And Methods: The study was performed retrospectively on 28 consecutive patients (age, 37-57 years; mean, 48 y +/- 4.81) with 84 uterine leiomyomas. UAE was performed between June 2006 and August 2007. All tumors in all patients were evaluated. Magnetic resonance imaging was performed before UAE and 3 months and 1 year after UAE. The volume and location of each tumor were evaluated in consensus by two radiologists.

Results: The mean pre-UAE volume of the leiomyomas was 51.6 cm(3) (range, 0.72-371.1 cm(3); SD, 79.3). Seven tumors were submucous, 28 intramural, and 49 subserous. At 3-month follow-up, 83 tumors (98.8%) showed volume reduction (mean, 52.62% +/- 21.85%; range, 12.79%-96.67%) and one (1.2%) increased in volume. At 1-year follow-up, five tumors (6%) were undetectable, 72 (85.7%) showed a further volume reduction of 20.5% +/- 11.92% (range, 2.52%-58.72%) relative to the 3-month volume, and seven (8.3%) increased in volume. A statistically significant difference (P = .026 at 3 months and P = .0046 at 1 year) in percentage of volume change was observed based on tumor location; submucous tumors showed the greatest volume reduction and subserous tumors the least reduction. The initial tumor volume showed a weak negative correlation (Spearman correlation coefficients, -0.35 at 3 months and -0.36 at 1 year) with tumor volume change.

Conclusions: UAE results in leiomyoma volume reduction at 3-month and 1-year follow-up. The tumor location plays an important role in volume changes and the initial tumor volume plays a minor role. Further studies with larger numbers of submucous leiomyomas are needed.